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COVID Through the Eyes of Historians: Jennifer Gunn

Jennifer Gunn discusses the lessons we can learn from the 1918 pandemic
November 17, 2020

Many Americans have been shocked to read about the frenzied competition among states, health organizations, and the federal government to purchase critical medical supplies. COVID-19 has shown a national administration unprepared and unwilling to coordinate pandemic response pushing responsibility onto states, localities, and private entities, even as the coronavirus, like the 1918 influenza virus, demonstrates that it respects no political or geographic boundaries. In theory, in 1918, Minnesota was ideally positioned for a statewide, highly coordinated response the flu pandemic. The WWI-era Commission of Public Safety (CPS), with emergency powers that superseded those of the state health department and all state and private agencies, had been in place for more than a year before influenza appeared. While the CPS did issue an ordinance in October 1918 to ban public gatherings and essentially quarantine towns, the Commission actually hampered rapid responses to influenza by deferring enforcement to municipalities and a slew of other agencies. Inconsistent regulations literally drove people—and the virus—from Virginia, Minnesota, where public gatherings were prohibited, to nearby Eveleth, where the billiard halls and “soft drink parlors” were still open. Long-standing turf wars between the state health department, the Red Cross, and private health agencies over tuberculosis control work contributed to a poor cooperative response to the flu pandemic, as did the unwillingness of the United States Surgeon-General, the U.S. Army, and the Secretary of the Minnesota State Board of Health to mandate protective measures, restrict mobility, and facilitate the distribution of the short supply of medical personnel. Lack of consensus and reliance on voluntary measures could be deadly.

Analysis of 1918 data indicates that North American cities that acted early and consistently over a longer period of time to ban public gatherings, close schools, and implement isolation and quarantine measures had a single, flatter mortality curve and lower death rates. Within ten days of detecting its first influenza case, Minneapolis closed schools and made influenza a reportable disease so that the sick could be isolated. At the end of the pandemic, it had an excess death rate 55 percent lower than that of St. Paul, which employed different timing and interventions. As we are witnessing in the current pandemic, contending political, economic, and scientific positions undermine effective, coordinated response to a global pandemic. Local community organizations played a significant role in caring for the sick and producing needed supplies in 1918. While federal, state, and county governments debated and flailed, Red Cross chapters turned from rolling bandages for the military to making flu masks and pneumonia jackets.

Flattening the curve in 1918 enabled those still standing in rural areas and small towns to organize meals and basic home care for their neighbors bedridden with influenza. Social distancing in 2020 remains communities’ most significant protective response in the face of poorly coordinated and inconsistent governmental action.